Welcome to Dr. James Wilson's Adrenal Fatigue Blog

What is Adrenal Fatigue?

What is adrenal fatigue?

Your adrenal glands respond to every internal and external stress you experience by preparing your body to react to the stressor while maintaining your life-preserving homeostasis. They do this via the various hormones they produce, the primary one being cortisol. In adrenal fatigue the adrenal glands function, but below their optimal level. As a result, adrenal hormone output and the body’s ability to cope with stress are also diminished. Adrenal fatigue is different from Addison’s disease, which is the relatively rare extreme of low adrenal function primarily caused by damage to the adrenal glands from disease. Adrenal fatigue is not a disease and is usually associated with intense or prolonged stress. In these stressful times adrenal fatigue is so common that it is fatigued adrenal glandsestimated to affect most people at some time in their lives. Adrenal fatigue can be mild and transient, but millions of people are currently struggling with a cycle of diminished adrenal function and inescapable stress that can have considerable negative consequences for quality of life and overall health.

What does adrenal fatigue feel like?

As the name suggests, its main symptom is fatigue. This fatigue is not relieved by sleep and has a distinctive pattern that sets it apart from fatigue caused by other health or lifestyle factors. Its pattern primarily reflects the lowered daily fluctuations of cortisol that result from the reduced capacity of the adrenal glands to produce adrenal hormones. In adrenal fatigue, cortisol (which is normally highest at around 8 AM) is low in the morning making it harder for you to wake up and get going, even if you have had a full night’s sleep. The following are common to people experiencing adrenal fatigue:

stressed faded manDifficulty getting up in the morning
• Not fully awake until after 10 AM
• Needs caffeine to get going
• Energy low from mid to late afternoon
• Better energy after 6 PM until around 9 PM
• Second wind from around 11 PM to 1 AM
• Snacks on salty or sweet foods and caffeine to keep going
• Feels run down
• Harder to bounce back from illness or other stresses
• Difficulty concentrating and thinking clearly
• Lower libido
• Poor sleep
• Sick more often
• Increased symptoms with allergies, PMS or menopause

What causes adrenal fatigue?

Adrenal fatigue is produced when the output of regulatory adrenal hormones is diminished through over-stimulation of the adrenals by severe, chronic or repeated stress, or because of adrenals weakened by poor nutrition, congenital factors or other influences. The causes of adrenal fatigue usually stem from one of four common sources that overwhelm the adrenal glands:

1. Disease states such as severe or recurrent pneumonia, bronchitis or flu, cancer, AIDS, auto-immune and other illnesses
2. Physical stress such as surgery, poor nutrition, addiction, injury, and exhaustion
3. Emotional/psychological stress from relationships, finances, work or other unavoidable life situations
4. Continual and/or severe environmental stress from toxic chemicals and pollutants in the air, water, clothing or food

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Maintaining Sanity in Times of Stress: Stress Management Tips

Create a sense of control over the situation (or your response to it)

bike in a field by Flickr user Fire At WillA diminished sense of control or mastery over life is a risk factor for depression, and hopelessness can literally transform stress into depression.12 Increasing your sense of control can reduce this risk. If you are feeling stressed, find a way to exert at least some control over the situation. Sometimes just discussing a problem with a supportive friend (not ruminating to yourself, which is associated with depression) and strategizing possible solutions can bring a feeling of increased control over your life and what happens to you. Rarely is there a situation in which you cannot change some aspect or your perception of it, and even small changes can be empowering. Maybe you feel overwhelmed by everyone else’s demands on you and your time. Carving out even 15 minutes a day of self-time can help you feel more in charge of your life and reduce your risk of depression.

Be physically active

Exercise, especially strength training or cardiovascular activity (walking briskly, cycling, swimming, dancing), is a potent antidepressant, increasing endorphins—the “feel good” brain chemicals—and shown to be as effective as drugs and psychotherapy.8

Practice mindfulness

Mindfulness has proven to be beneficial with stress reduction, even in cancer patients who experience a high level of both physical and emotional stress. In mindfulness training, people are taught, with the help of meditative practice, to simply pay attention to what is present in the moment. This awareness is done without making judgments about the reasons for, relevance of, or effects of the experience. Immediately after the training, the participants experienced a better quality of life, more joy and less tension. A year later, participants not only maintained those effects, but also reported less depression, anger and mood disturbance, and more vigor.6

Avoid the use of alcohol

Alcohol can disrupt normal sleep patterns making it more difficult to cope with stress. Alcohol also disturbs blood sugar balance, sending it first higher and then allowing it to drop. The drop in blood sugar aggravates the mental and emotional effects of the alcohol and triggers a release of cortisol, putting yet another stress on already overworked adrenal glands. In addition, the metabolism of alcohol depletes B vitamins, crucial to the stress response.

Find a Friend

Loneliness may not be the first thing people think of when they think of a stressor, but loneliness increases the activity of the stress response system and is associated with depression, anxiety and cognitive decline.3, 11 Interventions to decrease loneliness have resulted in dramatic effects on depression reduction.

Support your stress response system

Nutrients particularly important for supporting the function of the adrenals and the stress response system include vitamin C, B6, zinc, magnesium and pantothenic acid. These all play a crucial part in supporting the health of the adrenal gland and in assisting a healthy cortisol response. Stress increases the need for these nutrients. Herbs such as eleutherococcus, ashwagandha and licorice help the body adapt to stress and maintain balance.

help sign by Flickr user LiminaMikeDon’t be afraid to ask for help

It takes strength to do it all alone, but it can take even more to ask for help. Depression, anxiety and other mental-emotional consequences of stress can be extremely painful and difficult to deal with—especially alone. Counselors, psychologists, and both medical and naturopathic physicians can offer options. Don’t be afraid to reach out.

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

References

1. Bhui KS, Dinos S, Stansfeld SA, White PD. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. J Environ Public Health. 2012;2012:515874. Epub 2012 Feb 14.
2. Brosschot JF, Benschop RJ, Godaert GL, Olff M, De Smet M, Heijnen CJ, Ballieux RE. Influence of life stress on immunological reactivity to mild psychological stress. Psychosom Med. 1994 May-Jun;56(3):216-24.
3. Chang EC, Hirsch JK, Sanna LJ, Jeglic EL, Fabian CG. A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model. J Couns Psychol. 2011 Jul;58(3):441-8.
4. Frodl T, O’Keane V. How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiol Dis. 2012 Mar 9. [Epub ahead of print]
5. HSE. Health and Safety Statistics 2006/2007. http://www.hse.gov.uk/statistics/overall/hssh0607.pdf
6. Kieviet-Stijnen A, Visser A, Garssen B, Hudig W. Mindfulness-based stress reduction training for oncology patients: patients’ appraisal and changes in well-being. Patient Educ Couns. 2008 Sep;72(3):436-42. Epub 2008 Jul 25.
7. Krugers HJ, Karst H, Joels M. Interactions between noradrenaline and corticosteroids in the brain: from electrical activity to cognitive performance. Front Cell Neurosci. 2012;6:15. Epub 2012 Apr 9.
8. Martinsen, EW. The role of aerobic exercise in the treatment of depression. Stress Medicine 1987; 3(2): 93-100.
9. Mikolajczak M, Quoidbach J, Vanootighem V, Lambert F, Lahaye M, Fillée C, de Timary P. Cortisol awakening response (CAR)’s flexibility leads to larger and more consistent associations with psychological factors than CAR magnitude. Psychoneuroendocrinology. 2010 Jun;35(5):752-7. Epub 2009 Dec 2.
10. Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002 Sep 25;288(12):1447-50.
11. VanderWeele TJ, Hawkley LC, Thisted RA, Cacioppo JT. A marginal structural model analysis for loneliness: implications for intervention trials and clinical practice. J Consult Clin Psychol. 2011 Apr;79(2):225-35.
12. Weir K.F.; Jose P.E. A comparison of the response styles theory and the hopelessness theory of depression in preadolescents. Journal of Early Adolescence, v28 n3 (2008 08 01): 356-374

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Maintaining Sanity in Times of Stress: How Stress Affects Mental Health

sad young man on benchIt’s not hard to see the physical effects of too much stress; things like muscle tension, fatigue, blood sugar imbalances and rising blood pressure (or dropping blood pressure with adrenal fatigue) are easy to recognize. However, sometimes stress takes an even greater toll on areas which aren’t as visible: your emotional health. Stress can contribute to depression, anxiety, irritability, cynicism, interpersonal problems, emotional exhaustion, and suicide. 1, 10 Chronically stressed people have a harder time responding to additional challenges and take a longer time to recover from them.2 Once you’re juggling the maximum number of balls you can handle, tossing in one more can bring the whole act tumbling to the ground and bring you to tears in the corner. This kind of stress puts a strain on your relationships and affects your ability to function at work. It’s hard to be productive when you can’t concentrate or remember details. A 2007 survey grouped stress, depression and anxiety together as the single largest cause of absences due to work-related illness.5

Stress can affect your mood in many ways. Stress hormones such as cortisol interact and interfere with various neurotransmitters such as serotonin and dopamine7 – brain chemicals involved in regulating mood. There is even evidence that exposure to excessive stress causes damage to brain structure in addition to function. 4

Image credit: Flickr user LeonskiA healthy stress response adapts to a challenge by mobilizing resources and energy, and then when the stress is over, shifting back into balance. Cortisol, secreted by the adrenal glands, is the primary stress hormone in humans and its main function is to help the body deal with all kinds of stress. Chronic pain, low blood sugar, or even giving a speech can induce a rise in your cortisol, which comes to the aid of your stressed body: reducing inflammation, raising blood sugar levels, assisting blood flow, and giving you the “edge” you need to meet the challenge. Once the stress is over, cortisol levels should drop and allow your body to rebalance. However, protracted stress can cause chronic cortisol elevation – and irritability, anxiety and depression. If the stress continues even longer, your adrenals can fatigue with the result that stress response system may not be able to continue to keep pace with the demand for cortisol. At this point, the stressors will still be there, but your ability to adapt to them and handle them will have diminished. Pain and inflammation can worsen, blood sugar levels may drop even lower – resulting in hypoglycemia and the related irritability, spaciness and fatigue. This makes it even more difficult to focus your thoughts or gather the “oomph” to take on any additional challenge, and depression can tighten its grip.

Dealing with stress, depression and its other emotional manifestations is difficult. However, it is possible to intervene in this downward spiral and improve your stress response and your mood.

Continue to part 2 – Stress Management Tips

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

References

1. Bhui KS, Dinos S, Stansfeld SA, White PD. A synthesis of the evidence for managing stress at work: a review of the reviews reporting on anxiety, depression, and absenteeism. J Environ Public Health. 2012;2012:515874. Epub 2012 Feb 14.
2. Brosschot JF, Benschop RJ, Godaert GL, Olff M, De Smet M, Heijnen CJ, Ballieux RE. Influence of life stress on immunological reactivity to mild psychological stress. Psychosom Med. 1994 May-Jun;56(3):216-24.
3. Chang EC, Hirsch JK, Sanna LJ, Jeglic EL, Fabian CG. A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model. J Couns Psychol. 2011 Jul;58(3):441-8.
4. Frodl T, O’Keane V. How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiol Dis. 2012 Mar 9. [Epub ahead of print]
5. HSE. Health and Safety Statistics 2006/2007. http://www.hse.gov.uk/statistics/overall/hssh0607.pdf
6. Kieviet-Stijnen A, Visser A, Garssen B, Hudig W. Mindfulness-based stress reduction training for oncology patients: patients’ appraisal and changes in well-being. Patient Educ Couns. 2008 Sep;72(3):436-42. Epub 2008 Jul 25.
7. Krugers HJ, Karst H, Joels M. Interactions between noradrenaline and corticosteroids in the brain: from electrical activity to cognitive performance. Front Cell Neurosci. 2012;6:15. Epub 2012 Apr 9.
8. Martinsen, EW. The role of aerobic exercise in the treatment of depression. Stress Medicine 1987; 3(2): 93-100.
9. Mikolajczak M, Quoidbach J, Vanootighem V, Lambert F, Lahaye M, Fillée C, de Timary P. Cortisol awakening response (CAR)’s flexibility leads to larger and more consistent associations with psychological factors than CAR magnitude. Psychoneuroendocrinology. 2010 Jun;35(5):752-7. Epub 2009 Dec 2.
10. Spickard A Jr, Gabbe SG, Christensen JF. Mid-career burnout in generalist and specialist physicians. JAMA. 2002 Sep 25;288(12):1447-50.
11. VanderWeele TJ, Hawkley LC, Thisted RA, Cacioppo JT. A marginal structural model analysis for loneliness: implications for intervention trials and clinical practice. J Consult Clin Psychol. 2011 Apr;79(2):225-35.
12. Weir K.F.; Jose P.E. A comparison of the response styles theory and the hopelessness theory of depression in preadolescents. Journal of Early Adolescence, v28 n3 (2008 08 01): 356-374

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Let’s Talk About Sex … and Stress: Supporting Your Sexual Response

Sex as natural stress relief

tiger by Tambako the Jaguar

This post is rated R for Rawwr

Some studies show that short term stress or anxiety can actually increase sexual response and sex hormone production. In this type of stress, a branch of the nervous system called the sympathetic nervous system (SNS) is activated. The SNS stimulates release of adrenaline and noradrenaline from the adrenal glands, which creates a “fight or flight” response, preparing the body to stand up to or escape a stressor and making your heart beat faster and stronger—which also happens when you are aroused sexually. Moderate activation of the SNS—with intense exercise, for example—facilitates sexual arousal in women. In fact, sex hormones temporarily increase in response to brief stress in both men and women. So even though chronic stress interferes with sexual response and inhibits production of sex hormones, short duration stress can actually assist libido!  However, subjective reports of arousal don’t always correspond to physiological measures of arousal. In order to find enjoyment from sex, it is important that both your body and your brain are into it.

What’s really intriguing is that not only does stress impact your sex life (see part 1 on the effects of stress on sex drive), but the reverse is true: your sex life can impact your ability to handle stress! Women who had positive physical contact from their partners prior to a stressful event exhibited significantly lower cortisol levels and heart rate responses to the stress. Interestingly, verbal support from partners did nothing to reduce the women’s stress response. In another study, intimacy in couples’ everyday life was associated with reduced daily cortisol levels. Intimacy seemed to offer a buffering effect against work-related elevations in cortisol.

Ways to enhance both your sexual response and your stress response:

  • massage by zaphodsotherheadGive and receive positive physical contact. Hold hands, dance, give your partner a back rub, hug each other. This helps combat the stress response, and it can foster a positive emotional connection. Both emotional and physiological arousal are important in a healthy sexual response.
  • Find ways to leave your stress outside the bedroom door. Write down the things that you need to remember so they will be less apt to intrude in your brain at inopportune times. Distraction can be a real mood-killer.
  • Try snuggling up with your love for a scary movie or paddling some class IV white water rapids together. Short term stress can increase sexual response.
  • Support your stress response system nutritionally. Herbs like ashwagandha and eleutherococcus (formerly Siberian ginseng) help your body adapt to stress, while maca has been shown to support healthy sexual function in both men and women.
  • If you have adrenal fatigue, support your adrenals with nutritional supplements – such as B vitamins, vitamin C, manganese, magnesium and adaptogenic herbs. This can help them produce the DHEA you need for libido as well as the cortisol you need to manage stress.
  • Hit the gym for a quick work out. A brief bout of intense exercise facilitates physiological arousal.
  • Keep it fun. Focus on the process rather than the end. Don’t add stress needlessly.
  • Make time to practice physical intimacy with your partner. This in itself can reduce cortisol levels, and reduced cortisol levels are associated with improved sexual response.

Don’t let stress take over the bedroom. Practice connection, inject a little excitement, and keep things fun. As you manage your stress response, you’ll be supporting your sexual response, and by supporting your sexuality, you’ll receive the added benefit of reducing your stress in the process.

Photo credits: Flickr users Tamboko the Jaguar and zaphodsotherhead

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

References

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006 Aug;44(8):1067-77. Epub 2005 Sep 30.
Brooks NA, Wilcox G, Walker KZ et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal woman are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-1162.
Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: on the stress-protecting role of intimacy. Psychosom Med. 2008 Oct;70(8):883-9. Epub 2008 Oct 8.
Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007 Jun;32(5):565-74. Epub 2007 May 11.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011 May;59(5):765-71. Epub 2010 Dec 30.
Hamilton LD, Rellini AH, Meston CM. Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med. 2008 Sep;5(9):2111-8. Epub 2008 Jul 4.
Lennartsson AK, Kushnir MM, Bergquist J, Billig H, Jonsdottir IH. Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. Int J Psychophysiol. 2012 Mar 9. [Epub ahead of print]
Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biol Reprod. 1991 Oct;45(4):523-32.
Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E.Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. Review.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007 Sep;45(9):2078-89. Epub 2007 Mar 19.
Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performance in patients with mild erectile dysfunction: a randomized, double-blind clinical trial. Andrologia. 2001 Apr; 41(2):95-9.

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Let’s talk about sex … and stress: The effects of stress on sex drive

It’s a Friday evening, and you’re looking forward to a special evening alone with your partner. You collect your things to leave the office … when your boss dumps an extra project on your desk for the weekend. Then some hotshot in a turbocharged sports car cuts you off, and you spill your drink on your lap. By the time you finally arrive at home, you realize you left your passion somewhere between your desk and the exit ramp.

The Relationship Between Stress and Sex

man not interested in sexThe relationship between stress and sex is complex, but clinicians and lovers have long recognized stress’s ability to interfere with human sexuality and reproduction. The stress response is controlled by the hypothalamic-pituitary-adrenal (HPA) axis. The sexual response is controlled by the hypothalamic-pituitary-gonadal (HPG) axis. Notice some similarities? The hypothalamus is a part of the brain that controls the “four Fs” of our most basic instincts: fighting, fleeing, feeding, and … mating. The hypothalamus directs the pituitary, or “master gland,” which is found as a small protrusion off of the hypothalamus. The pituitary controls the secretion of hormones throughout the body. Depending on the messages it receives from the hypothalamus, it may signal the adrenals to secrete cortisol, a stress hormone, or the gonads to secrete sex hormones. Stress hormones can impact and interfere with sexual function at all three levels of the HPG axis: at the brain, pituitary, and gonads.

However, in addition to stress hormones, the adrenals can also produce DHEA, a sex hormone. DHEA is a precursor to both testosterone and estrogen. Although testosterone is often thought of as a male hormone, women also have it in smaller amounts, and it has a strong impact on libido. In menstruating women, the ovaries are the major source of testosterone, but the adrenals contribute via their production of DHEA. After menopause, the adrenals become critical to a woman’s supply. If a woman has adrenal fatigue, not only will her production of stress hormones decrease, but her testosterone—and her libido—will too.

Higher stress is associated with reduced sexual functioning in general. Women who had higher levels of cortisol (the stress hormone) and lower levels of DHEA (the sex hormone) after watching an erotic movie experienced less physiological arousal than women with a lower cortisol/DHEA ratio. Prolonged stress has been shown to decrease sexual response in women, and women with greater levels of chronic daily stress report more sexual complaints.

Stress can interfere with sex on a psychological level, too. Cognitive distraction (thinking or worrying about problems) interferes with sexual functioning. So if you are ruminating about multiple stressors, it will be difficult to put your full attention on either your partner or your own sensations and responses.

Continue to part 2 – Supporting Your Sexual Response

Photo credit: Flickr user focus.recompose

References

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther. 2006 Aug;44(8):1067-77. Epub 2005 Sep 30.
Brooks NA, Wilcox G, Walker KZ et al. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal woman are not related to estrogen or androgen content. Menopause. 2008 Nov-Dec;15(6):1157-1162.
Ditzen B, Hoppmann C, Klumb P. Positive couple interactions and daily cortisol: on the stress-protecting role of intimacy. Psychosom Med. 2008 Oct;70(8):883-9. Epub 2008 Oct 8.
Ditzen B, Neumann ID, Bodenmann G, von Dawans B, Turner RA, Ehlert U, Heinrichs M. Effects of different kinds of couple interaction on cortisol and heart rate responses to stress in women. Psychoneuroendocrinology. 2007 Jun;32(5):565-74. Epub 2007 May 11.
Hamilton LD, Meston CM. The role of salivary cortisol and DHEA-S in response to sexual, humorous, and anxiety-inducing stimuli. Horm Behav. 2011 May;59(5):765-71. Epub 2010 Dec 30.
Hamilton LD, Rellini AH, Meston CM. Cortisol, sexual arousal, and affect in response to sexual stimuli. J Sex Med. 2008 Sep;5(9):2111-8. Epub 2008 Jul 4.
Lennartsson AK, Kushnir MM, Bergquist J, Billig H, Jonsdottir IH. Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. Int J Psychophysiol. 2012 Mar 9. [Epub ahead of print]
Rivier C, Rivest S. Effect of stress on the activity of the hypothalamic-pituitary-gonadal axis: peripheral and central mechanisms. Biol Reprod. 1991 Oct;45(4):523-32.
Shin BC, Lee MS, Yang EJ, Lim HS, Ernst E.Maca (L. meyenii) for improving sexual function: a systematic review. BMC Complement Altern Med. 2010 Aug 6;10:44. Review.
Ter Kuile MM, Vigeveno D, Laan E. Preliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women. Behav Res Ther. 2007 Sep;45(9):2078-89. Epub 2007 Mar 19.
Zenico T, Cicero AF, Valmorri L, Mercuriali M, Bercovich E. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performance in patients with mild erectile dysfunction: a randomized, double-blind clinical trial. Andrologia. 2001 Apr; 41(2):95-9.

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How to Save Your Sleep and Manage Stress

comfortable bed

How to save your sleep and manage your stress

Now that we’ve discussed the sleep-stress connection, let’s talk about how to save that precious sleep and better manage stress. Higher subjective ratings of stress during the day are associated with poorer sleep. Conversely, poorer sleep is associated with higher ratings of stress during the day. Therefore, anywhere you are able to impact this vicious cycle is likely to help both.

  • Try to maintain a regular bedtime and waking time to reinforce the daily cycle.

  • Light is a factor in maintaining the daily rhythm. Avoid staring at a bright television or computer screen an hour before bedtime, and keep your bedroom as dark as possible while you sleep.
  • Have a small snack including complex carbohydrate (whole grains, root vegetables, etc.) and protein (nuts, chicken, fish, eggs, etc.) before bed to avoid low blood sugar during the night and a resultant rise in cortisol.
  • Minimize nighttime interruptions. Turn off your phone, and if noise is a factor where you sleep, try using white noise to relax and dampen sounds.
  • Vigorous exercise can help dissipate stress. However, a high intensity work out late in the evening may interfere with sleep. Gentle exercise just before bed, especially for those with adrenal fatigue, may promote sleep.
  • Support the adrenals and HPA axis with nutrients and adaptogens, herbs that help the system respond to stress, such as eleutherococcus (formerly Siberian ginseng), ashwagandha, maca and licorice.
  • Socialize with friends. It relieves stress and supports the adrenals.
  • Practice some form of relaxation and stretching such as yoga. In a trial looking at the effects of either an 8 week yoga or an 8 week educational film program on stress, mood and blood pressure in postmenopausal women, the yoga group showed significant improvements in sleep quality, mood, perceived stress and blood pressure compared to the film group.

Don’t lose sleep over stress. Support your sleep pattern and your stress response to get a better night’s sleep and avoid some of the problems associated with stress and long term sleep disorders.

References

Aldabal, L. and A. S. Bahammam (2011). “Metabolic, endocrine, and immune consequences of sleep deprivation.” Open Respir Med J 5: 31-43.

Backhaus, J., K. Junghanns, et al. (2004). “Sleep disturbances are correlated with decreased morning awakening salivary cortisol.” Psychoneuroendocrinology 29(9): 1184-1191.

Balbo, M., R. Leproult, et al. (2010). “Impact of sleep and its disturbances on hypothalamo-pituitary-adrenal axis activity.” Int J Endocrinol 2010: 759234.

Benedict, C., W. Kern, et al. (2009). “Early morning rise in hypothalamic-pituitary-adrenal activity: a role for maintaining the brain’s energy balance.” Psychoneuroendocrinology 34(3): 455-462.

Eek, F., B. Karlson, et al. (2012). “Cortisol, sleep, and recovery – Some gender differences but no straight associations.” Psychoneuroendocrinology 37(1): 56-64.

Garde, A. H., K. Albertsen, et al. (2011). “Bi-directional associations between psychological arousal, cortisol, and sleep.” Behav Sleep Med 10(1): 28-40.

Innes, K. E. and T. K. Selfe (2012). “The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS): A Preliminary Randomized Controlled Trial.” Evid Based Complement Alternat Med 2012: 294058.

Lattova, Z., M. Keckeis, et al. (2011). “The stress hormone system in various sleep disorders.” J Psychiatr Res 45(9): 1223-1228.

Spath-Schwalbe, E., T. Scholler, et al. (1992). “Nocturnal adrenocorticotropin and cortisol secretion depends on sleep duration and decreases in association with spontaneous awakening in the morning.” J Clin Endocrinol Metab 75(6): 1431-1435.

Woods, N. F., E. S. Mitchell, et al. (2009). “Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study.” Menopause 16(4): 708-718.

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Got Stress? How’s Your Sleep?

The sleep-stress connection

fragmented stressed woman by ZolfoWho hasn’t experienced a restless night full of tossing and turning from worry about a test, interview or presentation the next day? Stress and worry affect your quality of sleep which, in turn, affects your ability to handle stress. Difficulties with sleep or stress management can produce a vicious circle of decreased sleep and increased stress.

Although the sleep-stress link is complex, and researchers are unclear on the exact physiology behind it, we do have some clues. The hypothalamic-pituitary-adrenal (HPA) axis is the primary regulator of the stress response. The hypothalamus, a part of the brain, directs the pituitary, another gland in the brain, to signal the adrenal glands, located above the kidneys. In response to this signal the adrenal glands secrete stress hormones, like adrenaline and cortisol, that have widespread effects throughout the body: raising blood pressure, elevating blood sugar, increasing heart rate, and even causing anxiety.

The level of cortisol the body produces has a normal daily rhythm that somewhat parallels the normal sleep-wake cycle. Cortisol peaks in the early morning, declines throughout the day, and reaches a low around midnight. The level starts to rise again during the second half of the night. However, many types of stress (extreme physical activity, worry about a family member’s health, going too long between meals) can trigger the stress response and disrupt this normal cycle.

Excessive stress can cause healthy adrenal glands to increase cortisol output throughout the day and into the evening, putting a burden on the body from all the metabolic changes induced by the hormone. On the other hand, in people with adrenal fatigue, cortisol levels typically can’t reach their normal morning high or rise in response to demand, making it more difficult to handle any stress.

Effects of lack of sleep

alarm clock and sleeping womanProlonged insomnia is associated with elevated nighttime cortisol levels and lower morning cortisol levels. People who chronically sleep less than 9 hours a night tend to have higher cortisol levels throughout the time that they sleep and are at higher risk for obesity and diabetes than people who sleep for more than 9 hours.

The evidence for the relationship between short-term lack of sleep and cortisol is a bit more contradictory. After a period of sleep loss, some studies show elevation of cortisol, while others report a decrease in cortisol. Some researchers theorize that, initially, the stress response system is stimulated in order to cope with and adapt to sleep loss, but over time the continued lack of sleep causes a blunting of the response. This could also be due to an inability of the adrenal glands to continue to respond to the stressor.

One of the primary functions of sleep is to consolidate new memories. Much of this process involving memories about facts and information happens during slow wave sleep, which occurs in the early night. When low dose cortisol was given to people during this sleep phase (similar to what could occur in the body under stress), their memory was impaired.

Although we’re not clear on which may be the proverbial chicken or egg, sleep disturbances and cortisol imbalances are both common in insomnia, depression, sleep apnea, restless leg syndrome, menopause, Cushing’s syndrome (a syndrome in which cortisol is significantly high) and adrenal fatigue (in which cortisol is significantly low).

Continue to part 2: How to Save Your Sleep and Manage Your Stress

About the author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

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Saving Sleep, Sex and Sanity in a Stressful World: Introduction

Got stress? That’s a pretty easy question to answer, and one to which most of us would reply to with an emphatic “Yes!” Here’s another question: How’s your sleep, sex and sanity? Most of us can name at least one of those areas as something we’d do anything to save, as well as hundreds of reasons how it got so bad in the first place, like:

I’m just too tired.
I’m too busy to think about it right now.
I’ll catch up on sleep over the weekend.
I’ll feel better when …

Stress can be bad news for sleep, sex and sanity. For the rest of April, which is National Stress Awareness month, we’re focusing on each of these topics and just how stress affects each one. Better yet, we’ll share what you can do to save your sleep, sex and sanity in a stressful world. Here’s an overview to get started:

businesswoman asleep on the couchSleep

Stress and worry affect your quality of sleep, and your quality of sleep, in turn, affects your ability to manage stress. Difficulties with either sleeping or managing stress can result in difficulties in the other, causing a vicious circle of decreased sleep and increased stress.

 

rose petals on a pillowSex

A healthy sex life is affected by libido, performance, energy and opportunity – all of which can be undermined by stress. Stress related psycho-emotional factors that put additional strains on relationships and self-image, as well as adrenal fatigue and metabolic syndrome, can also put a damper on sexual health and performance.

 

man going insaneSanity

Feeling stressed is synonymous with feeling unhappy, pressured, dissatisfied, chaotic and a little crazy. Depression, PTSD and neurotic behavior are just some of the mental health issues caused or exacerbated by high or chronic stress.

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Signs and Symptoms of Stress

stressed woman holding her faceIn order to get a true grasp on stress, you first must learn how to recognize it in yourself. The mind, body and judgment are affected by stress in many ways, and they’re all directly tied to the physiological changes of the fight-or-flight response. There are no set signs and symptoms of stress, as these vary widely from person to person. Some experience primarily physical symptoms, like lower back pain, stomach problems and outbreaks on the skin. In others, the stress pattern centers around emotional symptoms, such as crying spells or hypersensitivity. For others, the changes mostly affect their behavior or thought processes. Below are some of the more common signs and symptoms of stress, broken down by category. (It’s important to note that the signs and symptoms of stress can also be caused by other psychological and medical problems.)

Cognitive Symptoms       

  • Forgetfulness
  • Poor short-term memory
  • Difficulty focusing
  • Indecisiveness
  • Difficulty concentrating
  • Trouble thinking clearly
  • Poor behavior/being unlike one’s self
  • Focusing on the negative
  • Racing or anxious thoughts

Emotional Symptoms

• Constant worrying
• Fearful anticipation
• Agitation and moodiness
• Restlessness
• Short temper
• Irritability, impatience
• Inability to relax
• Feeling tense and “on edge”
• Feeling overwhelmed
• Sense of loneliness and isolation

Behavioral Symptoms

• Decrease in sex drive/libido
• Eating less or more then usual
• Habitual craving for salty or sweet foods
• Sleeping too much or too little
• Neglecting responsibilities
• Avoiding contact with others
• Using alcohol, tobacco, or drugs to unwind
• Nervous habits (e.g. pacing or nail biting)
• “Overdoing it” (e.g. exercising, working)
•  Using caffeine to stay going
• Becoming argumentative or combative
• Overreacting to unexpected problems

Physical / Physiological Symptoms

• Chronic fatigue
• Tense pain in head and/or back
• Stiffness and tension in muscles
• Constipation or diarrhea
• Nausea, dizziness
• Difficulty sleeping/insomnia
• Increased heart rate/chest pain
• Increase or decrease in blood pressure
• Loss or gain in weight
• High or low blood sugar
• Skin conditions (e.g. eczema, hives)
• Frequent or prolonged colds

If you’re experiencing any of the warning signs of stress, it’s important to see your health-care professional for a full evaluation. A healthcare practitioner who is familiar with how stress and adrenal fatigue affects overall health can help you determine whether or not your symptoms are related to stress. Dr. Wilson’s Adrenal Fatigue Program may help your adrenal glands and the stress response system better cope with stress. Providing you make appropriate diet and lifestyle changes, you can help put an end to the suffering caused by 21st century stress.

About the Author

Dr Eric BakkerEric Bakker B.H.Sc. (Comp.Med), N.D, R.Hom. is a highly experienced naturopathic physician who has been in clinical practice for 25 years. Eric is passionate about improving people’s lives through proven wellness and lifestyle principles, natural medicine practice as well as public and professional practitioner education. Eric specialises in candida yeast infections, as well as adrenal fatigue, and thyroid disorders. Dr. Bakker has written one of the most comprehensive books on yeast infections called Candida Crusher. Website:  candidacrusher.com  You can complete his online survey to determine if you have a yeast infection here, or link through to his many You Tube videos: www.yeastinfection.org  Dr. Bakker’s Blog:  www.ericbakker.com

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